Ducey rolls back COVID restrictions on hospitals, nursing homes

Citing a lower number of new cases and more people being vaccinated against COVID-19, Arizona Gov. Doug Ducey on Thursday rescinded a series of executive orders that limited elective surgeries and locked down nursing homes in the state.

Ducey issued an executive order that rolled back restrictions that were imposed in March and April 2020, including previous orders that halted elective surgeries entirely and then limited them, in order to maintain hospital capacity in the face of the coronavirus pandemic. Also lifted was an order that put strict limits on visitation in nursing homes and the movement of residents of long-term care facilities.

"With nearly three and a half million vaccine doses administered across Arizona, we're on track to fighting off the pandemic and returning to normal," Ducey said in a press release. "At the beginning of the pandemic, we took necessary measures to protect vulnerable populations and all Arizonans. Now the vaccine is out far and wide, and we have much better knowledge of the virus than we did before. I'm grateful to the hospitals, medical professionals and long-term care facilities that prioritized Arizonans' safety, and I'm looking forward to scaling back on measures that are no longer needed."

Ducey has scaled back other measures in recent weeks, including again blocking cities, counties and other local governments from mandating that face masks be worn in public. Both the city of Tucson and Pima County have refused to adhere to Ducey's attempt to limit their ability to impose a mask requirement.

Pima County Supervisor Matt Heinz blasted the governor's move to loosen restrictions on hospitals and long-term care centers, saying "Fortunately Pima County and other local jurisdictions are standing up for their residents and for sensible public health restrictions when necessary — like the countywide mask requirement that remains in effect and especially on bringing additional federally sourced vaccines into low-income and Latino areas."

"The state and our governor continue to play politics with the lives of our people; it's shameful and disappointing," Heinz, a Democrat who works as a medical doctor at a local hospital, told TucsonSentinel.com on Thursday.

Last March 19, Ducey issued an order to temporarily halt non-essential elective surgeries. On April 22, 2020, ordered that elective surgeries could resume if certain criteria were met. Those limits were removed Thursday.

"With cases continuing to decline, today's order provides hospitals with the flexibility to conduct elective surgeries," said the news release from the Republican governor's office.

Last April 7, Ducey ordered limits on visits to nursing homes, and required residents to quarantine if they left and returned.

"With vaccination efforts well underway, new guidelines from federal partners, and the input of the Arizona Task Force on Long-Term Care, Arizona is now able to roll back some of those limitations and help facilitate additional visitation as well as off-site visits for long-term care residents without the need for quarantine upon return," the statement from the governor's office said.

The combination of rollbacks and the continued spread of new, potentially more dangerous variants of the virus have many public health experts concerned their may be yet another deadly wave of COVID in Arizona, despite the trend of fewer cases over recent weeks.

There were 381 new cases of infected Arizonans reported Thursday, with 10 new deaths reported. Nearly 17,000 state residents have died from coronavirus in the past year, with more than 840,000 diagnosed cases. There have been 112,000 cases and 2,350 deaths in Pima County.

Ducey lifts restrictions on bars, blocks mask orders

Last Thursday, Ducey lifted restrictions on bars, and ordered cities and counties from mandating face-covering be worn in public— a move called "irresponsible, unethical and unprecedented" by the chair of the Pima County Board of Supervisors and "premature" and "reckless" by the mayor of Tucson.

In a memo last week, Pima County Administrator Chuck Huckelberry asked the county attorney to consider how the county would need to modify the emergency-related public health resolutions to be consistent with the governor's order. In his memo, Huckelberry noted that wastewater surveillance testing for coronavirus detected the U.K. variant, or B.1.1.7, "confirming its widespread presence" here.

"This variant in particular is concerning because it is more easily transmitted and also potentially more likely to cause severe disease and even death," Huckelberry wrote. "This type of variant expansion is not uncommon or unexpected, but it does create a greater urgency in order to achieve a level of community immunity before the new variants take hold," he wrote. "Therefore, a public health reason to remain vigilant and retain rules related to preventing the spread of COVID-19 and its variants."

Last Friday, ADHS reported that another variant,  known as the South African variant, or B.1.351, was confirmed in two test samples from the state. 

Last week, Dr. Francisco Garcia, the county's chief medical officer, said that the county was in an "arms race," pitting vaccinations against the new variants of COVID-19.

Face masks are still required in public in Pima County, despite an executive order last week from Gov. Doug Ducey declaring that Arizona cities and counties should no longer mandate them, officials said.

Ducey does not have the legal authority to prevent the county's Health Department from "enacting reasonable public health measures," they said Monday, and officials will continue to enforce a December resolution by the Board of Supervisors, which mandates that everyone over the age of 5 must wear a face mask over their nose and mouth, unless they have a qualifying exemption, or are able to maintain physical distance.

Garcia called masks "a game-changer in this county" to mitigate the spread of COVID-19, and called Ducey's order to end mask mandates "executive overreach." 

Garcia said that it was "unfortunate" that the governor had taken this action because it led to mixed messages that the pandemic was over.

"Our goal here isn't to fight with the governor," he said, but rather that the county needs to "buy enough time to get a greater penetration of vaccine coverage." 

"Most citizens are doing the right thing and we want to continue to give them the tools they need to demand masks in public spaces," said Garcia.

A spokesman for the governor called Pima's reiteration of the requirement "completely inconsequential; they never enforced the mask mandate."

"The Arizona Department of Health is continuing to recommend that Arizonans wear masks, and practice social distancing, wash their hands and follow health guidance," said spokesman C.J. Karamargin.

While Pima County has not issued any citations nor revoked any business permits due to violations of the mask mandate, local Health Department officials and others have spent months carrying out educational visits and responding to reports of restaurants and other businesses that might be violating the public health measures.

Fourth wave?

In recent weeks, officials have warned of the possibility of a fourth wave in cases, as states begin to tear down mitigation efforts, and the new variants drive up new cases. During a briefing at the White House, the new director of the CDC, Rochelle Walensky, said there are "continuing concerning trends," including a rise in the number of infections, hospitalizations, and deaths.

"I'm going to pause here, I'm going to lose the script and I'm going to reflect on the recurring feeling I have of impending doom," Walensky said. "We have so much to look forward to. So much promise and potential of where we are and so much reason for hope. But right now I'm scared."

After passing the mask mandate on December 4, the Board of Supervisors followed with a curfew, requiring businesses to close between 10 p.m. and 5 a.m., however that was struck down in January when a judge ruled that the attempt to mitigate COVID-19 cases was "not statutorily authorized," and violated Ducey's executive orders. 

"We believe that we stand on solid ground," Garica said. "Do we anticipate that we'll be challenged on this? Absolutely, and bring it on," he said. 

County health inspectors will continue to enforce the mask mandate at places regulated by the Health Department, which is primarily places preparing or serving food.

Garcia said that county officials don't have a "mask police," but would rather depend on complaints about the use of masks, which will be followed with a phone call. County officials will "work with" business owners, Garcia said, and will attempt to continue public education efforts to convince business owners to require masking. However, he warned that business owners would face a "three-strikes" policy, and if the county continues to receive complaints, a business owner could be cited. The county added that a business could be fined $500 per infraction, and could face "suspension or revocation of its operating permits." 

"This pandemic is not over. There are still hundreds of thousands of people in Pima County who are not vaccinated and who remain at risk for serious illness or death if they contract COVID-19," Garcia said. "The best protection they have until they get vaccinated is for everyone to continue to wear their masks."

In Pima County, more than 29 percent of people have received at least one dose of the vaccine, not including those vaccinated by the state-run point-of-delivery based at the University of Arizona—which has covered nearly 80,000 people, according to figures from the Arizona Department of Health Services. 

"In another two to three months, we will have achieved a level of vaccination that allows this community to take a deep breath, but we're not there yet," he said. "I know that feels onerous, I know that feels tiring—people are sick of it, I'm sick of it. But the deaths, and cases, and the hospitalizations are real," Garcia said, adding that the county still endures more cases than the number of cases reported on Memorial Day week in May 2020.